Huge retroperitoneal liposarcoma with renal involvement requires nephrectomy: A case report and literature review

Abstract

Abstract.A 60-year-old female visited Guihang Guiyang Hospital (Guiyang, China). She presented with abdominal pain in the right side for the previous 2-months, with a touchable mass identified for the previous 1-month. Computed tomography with magnetic resonance imaging revealed a huge mass in the right abdomen. The diagnosis of well-differentiated retroperitoneal liposarcoma with renal involvement was made. During surgery, the tumor was removed, including the fatty renal capsule; however, the kidney was preserved. It is currently debatable whether resection of adjacent organs is required to obtain the negative margins. Conventional viewpoints advise that multi-organ resection is required in order to obtain the negative-margin. However, even if an R0 resection is achieved, the local recurrence rate remains markedly high. Additionally, the complications of organ resection have more impact on patients. Radiotherapy and chemotherapy are an important adjuvant method for these patients. In conclusion, retroperitoneal liposarcoma is a rare disease with a high rate of recurrence. Complete resection is the predominant treatment; however, combined resection of adjacent organs must be considered.

Laparoscopic approach to an incidentally found pelvic retroperitoneal liposarcoma

“…[2] WDLPS have no risk of metastasis but a high risk (60%) of local recurrence because defects of the retroperitoneal fat might create a niche for recurrence. [5] In our review, the risk of recurrence was 24.1%: 7 patients had been previously treated with surgery only, [2,8,16,23,29,31,33] whereas 2 patients received also chemotherapy [8,31] and 1 patient also received radiotherapy at the time of 2nd recurrence. [8] Because these tumors are classically chemo and radio resistant, surgical resection is essential to avoid recurrence.…”

“…[8,10,13,15–19,24,33] Postsurgical treatment was reported in 28/32 (87.5%) patients: 23/28 (82.1%) patients received no adjuvant therapy, 2/28 (7.1%) patients received chemotherapy, [8,10] 2/28 (7.1%) patients received radiation therapy, [12,13] and 1/28 (3.6%) patient received both chemo and radiotherapy. [29]…”

“…[8] One patient of 7 (14.3%) had 1 recurrence that was treated with surgery and chemotherapy, she was FOD at 8 months from relapse. [31] Four patients of 7 (57.1%) had 1 recurrence that was surgically treated, 1 patient recurred after 16 months, [29] 1 after 20 months, [2] 1 after 35 months, [16] and 1 after 84 months. [23] After surgery 3 patients remained FOD [2,16,29] while we did not find follow-up information about 1 patient.…”

“…[31] Four patients of 7 (57.1%) had 1 recurrence that was surgically treated, 1 patient recurred after 16 months, [29] 1 after 20 months, [2] 1 after 35 months, [16] and 1 after 84 months. [23] After surgery 3 patients remained FOD [2,16,29] while we did not find follow-up information about 1 patient. [23] Survival information were available for 27/32 (84.4%) patients, 26/27 (96.3%) patients were FOD and 1/27 (3.7%) patient died with disease (DWD) 84 months after diagnosis.…”

“…Among FOD patients, 16/26 (61.5%) had been treated with only tumor excision, 9/26 (34.6%) with tumor excision plus multiorgan resection and 1/26 (3.8%) patient with surgery plus adjuvant chemo and radiotherapy. [29] Five of 26 (19.2%) FOD patients had 1 or more recurrences. [2,16] In these patients, median DFS was 20 months, median OS was 28 months (ranging from 11 to 288 months).…”